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Tobiano G, Roberts S, Muir R, Jerofke-Owen T, Ting C, Thorning S, Heyland DK, Marshall AP. Patient-mediated interventions in hospital: A systematic review. J Adv Nurs 2023; 79:418-441. [PMID: 36408930 DOI: 10.1111/jan.15500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/13/2022] [Accepted: 11/06/2022] [Indexed: 11/22/2022]
Abstract
AIMS To describe the characteristics of hospital-based, patient-mediated interventions and their impact on patient, clinician and organization outcomes. DESIGN Systematic review. DATA SOURCES Health literature databases (MEDLINE, CINAHL and EMBASE) were searched in August 2021. Backward and forward citation searching was conducted. REVIEW METHODS Studies investigating patient-mediated interventions, targeted at adult hospitalized patients were eligible. Data were extracted related to study and intervention characteristics. Narrative synthesis was used to understand intervention impact on patient, clinician and organization outcomes (as per a framework). Methodological quality was assessed using the Mixed Methods Assessment Tool. RESULTS Thirty-three studies, reporting 18 interventions, were included. Twelve interventions prompted patients to report health information about their own health/needs/concerns and six interventions encouraged patients to provide feedback about clinical practice. Across all interventions, there was evidence that patients used patient-mediated interventions and that they may improve patient communication. Healthcare professional outcomes were mixed for actual/intended use, acceptability and usefulness of interventions; yet there was some evidence of healthcare professional behaviour change. Interventions that encouraged patients to report health information about their own health/needs/concerns appeared more successful than other types of interventions. CONCLUSIONS There is some evidence that hospital-based patient-mediated interventions may influence patient communication and healthcare professional behaviour. Patient-mediated interventions that encourage patients to report patient data before a clinical encounter may be more impactful than interventions that encourage patient feedback during or post-encounter. IMPACT To date, most patient-mediated intervention research has been conducted in primary care settings; we uncovered the types of patient-mediated interventions that have been trialled in hospitals. We found that patient communication and healthcare professional behaviour may be influenced by these patient-mediated interventions. Future researchers could explore the suitability and effectiveness of a wider range of hospital-based patient-mediated interventions. NO PATIENT OR PUBLIC CONTRIBUTION There was no funding to remunerate a patient/member of the public for this review.
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Affiliation(s)
- Georgia Tobiano
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia.,NHMRC CRE in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Shelley Roberts
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Rachel Muir
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | | | - Christine Ting
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Sarah Thorning
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada.,Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
| | - Andrea P Marshall
- Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
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Schubert EC, Galambos CM, Jerofke-Owen T, Arrington E, Jordan GC, Lodh N, Paquette H, Chelimsky G, Piacentine LB. Building a community-academic partnership to improve screening for intimate partner violence: Integrating advocates in healthcare clinic settings. J Adv Nurs 2022; 79:1603-1609. [PMID: 35621342 DOI: 10.1111/jan.15284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/24/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
AIMS To develop an innovative community-academic partnership to advance, test and promote intimate partner violence screening and referral protocols by comparing the effect of integrating intimate partner violence advocates versus enhancing medical training in medical clinic settings serving women from vulnerable populations. Detecting intimate partner violence in healthcare settings allows for survivors to connect to safety and referral resources prior to violence escalating. Screening for intimate partner violence and connecting patients to referral resources requires creating a safe and trusting relationship between healthcare providers and patients. Developing screening and referral protocols responsive to survivors' needs requires involvement of clinic staff, survivors and community agencies that support survivors. DESIGN Three phases of the project include Discovery, Implementation and Dissemination. Mixed-methodology will help in understanding current practices and effects of interventions. METHODS Actions included in each phase: Discovery: 1) nurse-led focus groups of clinic staff, providers and survivors to understand current clinic practices; 2) retrospective chart review of the number of screens performed, positive screens detected and interventions performed. IMPLEMENTATION 1) randomization of patients to be interviewed by a trained advocate or by healthcare provider with enhanced training; and 2) assess the number of screenings and referrals performed in each arm and 3) evaluate outcomes of intervention. Dissemination through: presentations, manuscripts and policy recommendations at the institutional and regional level. This IRB-approved proposal was funded in July 2021 by an Advancing a Healthier Wisconsin grant. DISCUSSION The partnership has improved channels of communication and understanding between diverse clinical care providers, survivors and community agency staff as they navigate the complex challenges to the development and integration of screening and referral protocols. IMPACT This project will provide evidence of the most effective intimate partner violence screening and referral methodology that can be utilized in a wide variety of medical settings.
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Affiliation(s)
| | - Colleen M Galambos
- University of Wisconsin Milwaukee Helen Bader School of Social Welfare, Milwaukee, Wisconsin, USA
| | | | - Erica Arrington
- Medical College of Wisconsin Department of Psychiatry and Behavioral Medicine, Milwaukee, Wisconsin, USA
| | - Greer C Jordan
- Medical College of Wisconsin Institute of Health & Equity, Milwaukee, Wisconsin, USA
| | - Nilanjan Lodh
- Marquette University College of Health Sciences, Milwaukee, Wisconsin, USA
| | - Heidi Paquette
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | - Gisela Chelimsky
- Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia, USA
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McAndrew NS, Jerofke-Owen T, Fortney CA, Costa DK, Hetland B, Guttormson J, Harding E. Systematic review of family engagement interventions in neonatal, paediatric, and adult ICUs. Nurs Crit Care 2020; 27:296-325. [PMID: 33089659 DOI: 10.1111/nicc.12564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/18/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023]
Abstract
AIMS AND OBJECTIVES The purpose of this systematic review was to evaluate interventions that have been used to engage families in direct care activities (active family engagement) in adult, paediatric, and neonatal intensive care unit (ICU) settings. BACKGROUND Family engagement is universally advocated across ICU populations and practice settings; however, appraisal of the active family engagement intervention literature remains limited. SEARCH STRATEGY Ovid Medline, PsycArticles & PsycInfo, Scopus, and CINAHL were searched for family interventions that involved direct care of the patient to enhance the psychological, physical, or emotional well-being of the patient or family in neonatal, paediatric, or adult ICUs. INCLUSION/EXCLUSION CRITERIA Studies were included if an active family engagement intervention was evaluated. Studies were excluded if they were not published in English or reported non-interventional research. RESULTS A total of 6210 abstracts were screened and 19 studies were included. Most studies were of low to moderate quality and were conducted in neonatal ICUs within the United States. Intervention dosage and frequency varied widely across studies. The interventions focused on developmental care (neonatal ICU) and involved families in basic patient care. Family member outcomes measured included satisfaction, stress, family-centred care, confidence, anxiety, and depression. Most studies found improvements in one or more outcomes. CONCLUSIONS There is a paucity of literature about active family engagement interventions, especially in adult and paediatric populations. The optimal dosage and frequency of family engagement interventions remains unknown. Our systematic review found that data are limited on the relationship between family engagement and patient outcomes, and provides a timely appraisal to guide future research. RELEVANCE TO CLINICAL PRACTICE Further research on the efficacy of family engagement interventions is warranted. The translation of active family engagement interventions into clinical practice should also be supported.
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Affiliation(s)
- Natalie S McAndrew
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.,Froedtert & the Medical College of Wisconsin Froedtert Hospital, Milwaukee, Wisconsin, USA
| | | | - Christine A Fortney
- College of Nursing, The Ohio State University, Martha S. Pitzer Center for Women, Children & Youth, Columbus, Ohio, USA
| | - Deena K Costa
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Breanna Hetland
- Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jill Guttormson
- College of Nursing, Marquette University, Milwaukee, Wisconsin, USA
| | - Eric Harding
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Jerofke-Owen T, Garnier-Villarreal M, Fial A, Tobiano G. Systematic review of psychometric properties of instruments measuring patient preferences for engagement in health care. J Adv Nurs 2020. [PMID: 32350898 DOI: 10.1111/jan.14402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/26/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
AIM To identify, critically appraise, and summarize instruments that measure patients' preferences for engagement in health care. DESIGN Psychometric systematic literature review. DATA SOURCES PubMed, Embase, CINAHL, and PsycINFO were searched from inception to March 2019. REVIEW METHODS Three reviewers independently evaluated the 'methodological quality' and the 'measurement properties' of the included instruments using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and Terwee's quality criteria. Each instrument was given a Grading of Recommendations Assessment, Development and Evaluation (GRADE) score. The review was registered at PROSPERO (registry number CRD42018109253). RESULTS A total of 16 studies evaluating 8 instruments measuring patients' preferences for engagement in health care were included. All instruments were downgraded for their 'methodological quality' or 'measurement properties', or a combination of both. Common concerns were lack of theoretical basis, absence of patient input during development, incorrect usage and reporting of validity measures and absence of a priori hypotheses to test validity. CONCLUSIONS There were no identified instruments that demonstrated adequate evidence for all measurement properties. The Patient Preferences for Patient Participation Scale (4Ps) and 10-item Decisional Engagement Scale (DES-10) had the highest overall GRADE scores; however, each had some underlying developmental or methodological issues. IMPACT Assessing how patients prefer to engage in their care is a critical first step to truly individualize engagement interventions to meet patient expectations. Systematic reviews of measures of patient experience with engagement in health care have been undertaken but none are available on measures of patient preferences for engagement. The results highlight the need to further develop and test instruments that measure patients' preferences for engagement in health care within a framework for consumerism. Involving the consumer in the instrument development process will ensure that engagement strategies used by healthcare providers are relevant and individualized to consumer preferences.
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Hanson L, VandeVusse L, Garnier-Villarreal M, McCarthy D, Jerofke-Owen T, Malloy E, Paquette H. Validity and Reliability of the Antepartum Gastrointestinal Symptom Assessment Instrument. J Obstet Gynecol Neonatal Nurs 2020; 49:305-314. [PMID: 32272088 DOI: 10.1016/j.jogn.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the psychometric properties of the nine-item Antepartum Gastrointestinal Symptom Assessment (AP-GI-SA) instrument. DESIGN Single-group prospective design. SETTING Urban prenatal clinic serving a diverse population. PARTICIPANTS Convenience sample of 45 pregnant women. METHODS Participants completed the AP-GI-SA before a scheduled prenatal care appointment. We used Bayesian structural equation modeling to evaluate the construct validity of the scale and assessed known-groups validity. We assessed reliability through maximal reliability coefficient estimate and measured internal consistency with Cronbach's alpha coefficient. RESULTS Participants completed the instrument in 2 minutes or less. Construct validity was supported by confirmatory factor analysis (posterior predictive p value = 0.49, gamma-hat = 0.970, and root mean square error of approximation = 0.065), which indicated that the single-factor model is a plausible data-generative model for GI symptoms. The maximal reliability coefficient of 0.75 and Cronbach's alpha coefficient of 0.67 supported reliability. Average AP-GI-SA scores were the highest for women in the third trimester. Of all nine GI symptoms, heartburn in the third trimester received the highest score. CONCLUSION Our findings provide preliminary support for the validity and reliability of the AP-GI-SA. The instrument may be used as a measure in intervention studies where GI symptoms of pregnancy are an outcome. The AP-GI-SA could also be useful in clinical settings to quickly evaluate GI symptoms.
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Jerofke-Owen T, Garnier-Villarreal M. Analysis of the Patient Preference for Engagement Tool. Nurs Outlook 2019. [DOI: 10.1016/j.outlook.2018.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Four focus groups were conducted to explore acute care nurses’ experiences empowering patients and the facilitators and barriers they encountered during the process. Thirty-four nurses employed at four hospitals in the Midwestern United States participated in the study between February and April 2015. Facilitators of empowerment included establishing a therapeutic relationship, fostering communication, providing education, respecting patient autonomy, engaging support systems, and lifting spirit/giving hope. Barriers included conflicting information about plans of care, lack of time, fear and anxiety over unfamiliar environments and routines, ineffective or inadequate support systems, lack of/low accountability, and killing the soul. Nurses also described innovative strategies they used to overcome the barriers. The development of future inpatient empowerment interventions needs to focus on the innovative strategies nurses used to overcome barriers in addition to considering the facilitators and barriers to empowerment that nurses identified.
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